Second Opinions

SECOND OPINIONS: Preventive Care: Are You Covered?

Christy Tinnes and Brigen Winters, with Groom Law Group, answer employer questions about health care reform.

By PS | October 28, 2015
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The Patient Protection and Affordable Care Act (ACA) generally requires group health plans to cover certain preventive care benefits at 100% with no cost-sharing.

These benefits include:

  • Evidence-based items or services with a rating of “A” or “B” under recommendations from the United States Preventive Services Task Force (USPSTF) [];
  • Immunizations recommended by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control [];
  • Preventive care and screenings for infants, children, and adolescents under Health Resources and Services Administration (HRSA) guidelines []; and
  • Preventive care and screenings for women under HRSA guidelines [].

PHSA § 2713(a); 29 CFR § 2590.715-2713(a). 

Experts from Groom Law Group answer some common questions about these requirements and outline recent guidance that plans should consider for 2016.